BACKGROUND: The primary aim of this study was to determine the cost-effectiveness of the reverse total shoulder arthroplasty in a prospective cohort of patients over a two-year post-operative period. METHODS: Patients who underwent reverse total shoulder arthroplasty were prospectively monitored for 24 months post-operatively using the Oxford Shoulder Score, Disabilities of the Arm, Shoulder and Hand questionnaire and EuroQol 5-dimensional questionnaire. Any complications or use of health care resources were recorded. The incremental cost-effectiveness ratio was used to express the cost per quality-adjusted life year gained. RESULTS: Sixty-seven patients were analysed, 46 primary reverse total shoulder arthroplasty for cuff arthropathy and 21 revisions from previous arthroplasty. Both indications had comparable peri-operative shoulder scores without significant difference. Using the mean change of EuroQol 5-dimensional questionnaire at one year, the incremental cost-effectiveness ratio was calculated at £16,827.43 per quality-adjusted life year, decreasing to £8313.48 per quality-adjusted life year at two years. Primary was associated with a lower incremental cost-effectiveness ratio at two years (primary £7596.76 vs. revision £11,748.51). The estimated post-operative life expectancy of the cohort was 6.9 years with a projected cost per quality-adjusted life year of £2438.78. CONCLUSIONS: Reverse total shoulder arthroplasty provides a cost-effective intervention with excellent patient outcomes at two years post-operatively.
BACKGROUND: The primary aim of this study was to determine the cost-effectiveness of the reverse total shoulder arthroplasty in a prospective cohort of patients over a two-year post-operative period. METHODS: Patients who underwent reverse total shoulder arthroplasty were prospectively monitored for 24 months post-operatively using the Oxford Shoulder Score, Disabilities of the Arm, Shoulder and Hand questionnaire and EuroQol 5-dimensional questionnaire. Any complications or use of health care resources were recorded. The incremental cost-effectiveness ratio was used to express the cost per quality-adjusted life year gained. RESULTS: Sixty-seven patients were analysed, 46 primary reverse total shoulder arthroplasty for cuff arthropathy and 21 revisions from previous arthroplasty. Both indications had comparable peri-operative shoulder scores without significant difference. Using the mean change of EuroQol 5-dimensional questionnaire at one year, the incremental cost-effectiveness ratio was calculated at £16,827.43 per quality-adjusted life year, decreasing to £8313.48 per quality-adjusted life year at two years. Primary was associated with a lower incremental cost-effectiveness ratio at two years (primary £7596.76 vs. revision £11,748.51). The estimated post-operative life expectancy of the cohort was 6.9 years with a projected cost per quality-adjusted life year of £2438.78. CONCLUSIONS: Reverse total shoulder arthroplasty provides a cost-effective intervention with excellent patient outcomes at two years post-operatively.
Authors: Eric C Makhni; Eric Swart; Michael E Steinhaus; Richard C Mather; William N Levine; Bernard R Bach; Anthony A Romeo; Nikhil N Verma Journal: Arthroscopy Date: 2016-04-28 Impact factor: 4.772
Authors: Richard S Boorman; Branko Kopjar; Edward Fehringer; R Sean Churchill; Kevin Smith; Frederick A Matsen Journal: J Shoulder Elbow Surg Date: 2003 Mar-Apr Impact factor: 3.019
Authors: Grant J Dornan; J Christoph Katthagen; Dimitri S Tahal; Maximilian Petri; Joshua A Greenspoon; Patrick J Denard; Stephen S Burkhart; Peter J Millett Journal: Arthroscopy Date: 2016-12-06 Impact factor: 4.772
Authors: Hassaan Abdel Khalik; Brittany Humphries; Michael Zoratti; Daniel Axelrod; Colin Kruse; Bill Ristevski; Krishan Rajaratnam; Michael Gardner; Jean-Éric Tarride; Herman Johal Journal: Clin Orthop Relat Res Date: 2022-05-04 Impact factor: 4.755